Clinical Analysis Of50Cases Of Severe Stenosis Of The Internal Carotid Artery Or Occlusion

Objective The study of carotid artery severe stenosis or occlusion in patients with clinical features and treatment method.Methods50patients (unilateral lesions in31cases, bilateral lesions in19cases) of Digital Subtract Angiography and/or Magnetic Resonance Angiography examination confirmed internal carotid artery severe stenosis or occlusion, according to the National Institute of Health stroke scale (NIHSS) divided into mild group and severe group, in its analysis of clinical features, biochemical indicators and treatment methods. On the acceptance of carotid artery stenting therapy in the patients preoperatively and postoperatively at24h by NIHSS score, preoperatively and3months postoperatively using a modified Rankin scoring criteria for these patients neurological function score. Patients were followed up for9-15months.Results50cases in this group are adult patients except one case children, the peak age of onset of60-year-old. The most common first symptom of ischemic cerebrovascular disease including cerebral infarction and transient ischemic attack (TIA). Internal carotid artery disease62, the initial segment disease is most common (36/62,58%). It is divided into mild group and severe group according to the National Institute of Health stroke scale (NIHSS),23cases of mild group (NIHSS<4points),27cases of severe group (NIHSS≥4points). Statistical analysis showed that the severity of neurological deficit combined with other cerebral vascular stenosis, collateral circulation compensatory obvious.19cases of intravascular interventional therapy, intraoperative angiography revealed26stents were placed successfully, preoperative degree of carotid stenosis [(90.4±9.1)%](70%-99%), degree of residual stenosis [(7.2±2.1)%](5%-10%), degree of luminal stenosis were obviously improved. Arrhythmia decreased in one patient, treated with intravenous atropine and gaze in patients with cough symptoms disappeared after. Postoperative, does not appear excessive perfusion, ischemia, embolus shedding, complications such as bleeding. After24h NIHSS patient nerve function score remained at the preoperative level [(3.2±3.3) points];3months after the operation, improved Rankin neural function score of [(1.58±1.78) points], with preoperative [(1.42±1.84) points] no significant difference between (T=1.837, P>0.05). Postoperative follow-up9-15months, except for one case of sporadic transient ischemic attack (TIA), other patients did not appear again TIA and new stroke, not found in stent restenosis case.Conclusion Ischemic stroke is the major clinical manifestation in ICASO patients. Internal carotid artery stenosis or occlusion is the most common initial segment. Internal carotid artery stenosis or occlusion of neurological function in patients with severe defect severity and combined with other cerebral vascular stenosis significantly related to compensatory collateral circulation. Intravascular interventional therapy of carotid artery severe stenosis or occlusion is the safe and effective treatment method.